Cardio Ventilation Perfusion Review PDF - 10 Sept 2024

PHSI N303F Cardiopulmonary Physiotherapy Review of Respiratory Physiology II Ven@la@on and Perfusion Ms Eva Chan Senior Lecturer Department of Physiotherapy, HKMU 10 Sept 2024 Learning objec-ves A"er the lecture, you should be able to:...

PHSI N303F Cardiopulmonary Physiotherapy Review of Respiratory Physiology II Ven@la@on and Perfusion Ms Eva Chan Senior Lecturer Department of Physiotherapy, HKMU 10 Sept 2024 Learning objec-ves A"er the lecture, you should be able to: define the ven6la6on and perfusion (V - ↓Os level * Attention to CO2 2. Cau3ons when providing supplementary oxygen therapy level Risk of inducing: ↳ can't too much Loss of hypoxic drive Worsened VB/QB mismatch due to reversal of hypoxic pulmonary vasoconstric3on Haldane effect >- Hb binds to 02 > - [CO2] ↑ HKMU Physiotherapy Effect of posi,oning Varies in adults and infants Decision should be based on clinical judgement and expecta8on on treatment outcomes HKMU Physiotherapy  Posi'oning in adults drain secretion Non-dependent -> easily more * Perfusion gradient v V q q Ven8la8on V v Q Q Dependent HKMU Physiotherapy  Posi%oning in infants Non-dependent Diseased lung Perfusion gradient Good lung at at uppermost V Ven:la:on uppermost v ® facilitates ® beAer Q drainage of Q oxygena%on secre%on Versus v v Q Q Dependent Rib cage of infants is more compliant than that of adults; Chest being put at dependent side will be compressed HKMU Physiotherapy After attending the lecture, try to answer the following questions. What is ven4la4on and perfusion (V;/Q; ) ra4o and its clinical importance? Compare the ven4la4on and perfusion at the apex of the lungs and that at the base of the lungs. Illustrate based on your knowledge of respiratory physiology. Explain the regulatory mechanism of hypoxic pulmonary vasoconstric4on. If you encounter an adult pa4ent having reduced air entry together with evidence showing accumula4on of secre4on at his/her right lung, how would you posi4on the pa4ent in side-lying? Will you put right lung at non- dependent or dependent posi4on? And, why? If this is a case of few months old, how would you modify your treatment in terms of the posi4oning? And, why? HKMU Physiotherapy References Hough, A. (2018). Hough’s cardiorespiratory care: an evidence-based, problem-solving approach (FiCh ediDon.). Elsevier. Koeppen, B. M., & Stanton, B. A. (Eds.). (2018). Berne & Levy physiology (Seventh ediDon.). Elsevier. Main, E., & Denehy, L. (Eds.). (2016). Cardiorespiratory physiotherapy : adults and paediatrics (FiCh ediDon.). Elsevier. Orr, Jeremy E., & Susan R. Hopkins. "Basics of VenDlaDon/Perfusion AbnormaliDes in CriDcally Ill VenDlated PaDents." Cardiopulmonary Monitoring: Basic Physiology, Tools, and Bedside Management for the Cri;cally Ill (2021): 189-204. West, J. B. & Luks, A. M. (2016). West’s respiratory physiology: the essenDals (Tenth ediDon.). Wolters Kluwer. HKMU Physiotherapy